Turkish Journal of Gastroenterology
Original Article

Diagnostics in cystic echinococcosis: Serology versus ultrasonography


Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany


Section Infection and Clinical Immunology, Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany


Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA


Department of Interventional and Diagnostic Radiology, University Hospital Ulm, Ulm, Germany


WHO Informal Working Group on Echinococcosis, Comprehensive Infectious Diseases Center, University Hospital Ulm, Ulm, Germany

Turk J Gastroenterol 2014; 25: 398-404
DOI: 10.5152/tjg.2014.7112
Read: 1867 Downloads: 685 Published: 25 July 2019


Background/Aims: Cystic echinococcosis (CE) is the most widespread zoonosis worldwide. The objective of the present study was to compare diagnostic methods in the work-up of suspected cystic echinococcosis of the liver.


Materials and Methods: Data from a total of 68 patients were compiled and analyzed.


Results: A diagnosis of cystic echinococcosis was made in 36.8% of patients. Broken down according to WHO criteria, patients with at least one echinococcus cyst were determined in 12.0% of cases to exhibit cysts consistent with stage 1 disease (CE1), while in 24.0%, cysts consistent with CE2 and CE3 were identified. CE4 and CE5 cysts were identified in 32.0% and 8.0% of patients, respectively. Solitary cysts were found in 60.0% of patients with cystic echinococcosis, while in patients with at least one cystic lesion, there were most often multiple cysts. The indirect hemagglutination test (IHA) and echinococcus-specific immunoglobulin E (IgE) concentration showed a higher sensitivity (60.9%, 68.4%) than did the enzyme-linked immunosorbent assay (ELISA) for Echinococcus multilocularis (Em2+) and total IgE (11.1%, 38.9%). The respective specificities of all four serological methods lay between 83.9% and 88.9%.


Conclusion: Our data show that ultrasound remains the diagnostic method of choice in the work-up of cystic lesions of the liver suspected to be due to Echinococcus granulosus. Serological methods can serve an adjunctive role.

EISSN 2148-5607